Micro-nutritional deficiencies, obesity and menopause
Can it be stated, without any hesitation, that people suffering from obesity automatically suffer from micro-nutritional deficiency. What is the link between obesity and menopausal symptoms.
What is Obesity?
According to the website of the National Institute of Public Health: At the population level, obesity is measured with the body mass index (BMI). BMI is the weight of a person (in kilograms) divided by their height (in meters) squared. A person with a BMI of 30 or more is considered obese (Health Canada, 2003). For example, a 178 cm (5’10”) man is considered obese if he weighs more than 95 kg (210 lbs.) and a 165 cm (5’5″) woman is considered obese if she weighs more than 81 kg (180 lbs.). However, it is recognized that obesity is underestimated because its measurement is based on self-reported information (weight and height).
Body Mass Index
The measurement of BMI as a factor in obesity is increasingly questionable, according to scientists:
Body mass index (BMI) is considered the best indicator of body fat, but more and more scientists believe that it is not as revealing as is commonly believed. In 2013, according to an editorial in the journal Science, it does not accurately measure the distribution and volume of that fat (it is less harmful when it is evenly distributed than if it is concentrated on the middle section, because it accumulates around internal organs) nor the percentage of muscle and fat tissue (bodybuilders can present the BMI of an overweight or obese person).
It is estimated that 24% of adults with “normal” BMIs actually show symptoms of insulin resistance (very frequent urination (urination), excessive thirst, extreme hunger, blurred vision, lack of energy and extreme fatigue, numbness and tingling in the hands and feet, slow healing of wounds and recurring infections) and are at higher than average risk of heart disease, perhaps because they have a lot of fat and little muscle. Conversely, 10% of adults who are “obese” according to BMI are healthy, probably because they are very muscular.
The Difference In BMI Between Individuals
According to Dr. Arya Sharma, Professor of Medicine and Chair of Obesity Research Chair at the University of Alberta, the index continues to be useful to health authorities, for example, who want to know if the national population is gaining weight. “On an individual level, BMI doesn’t mean much. Take two people who have exactly the same result: fat can account for 40% of body mass in one, who will have all the problems that come with obesity, and just 20% in the other, who will be healthy. »
BMI remains an important measure in assessing a client’s overall health but not the ultimate indicator of health.
Body Composition Analysis
There are several ways to measure body fat.
To the right, an example of body composition analysis using a scale that says it all! The Tanita SC240 is a fairly accurate representation of an individual’s body composition.
We can see that this person weighs 182lbs and that of this weight his body fat is equivalent to 72.16lbs, so 39.7% of his total weight is body fat.
According to the INSP (mentioned above), people with a BMI of more than 30 are considered obese. The results of the analysis on the right show that this person has a BMI of 28.6, below the critical threshold of 30. On the other hand, the results of the analysis also give a Physical Rating = Obese (2).
Another data that this analysis shows is the metabolic age. This person is 48 years old but his metabolic age is that of a 63 year old person!
The second section clearly shows us 4 parameters that we should take into account when analyzing body composition: BMI + % fat + % hydration + visceral fat content.
Let’s talk about Fat…
For a number of years now, the medical community has renamed fat mass as a toxic organ.
According to NIH (National Institute of Health) the study published in 2016 on the subject reveals the following:
Fatty tissue is a remarkably complex organ that has profound effects on physiology and pathophysiology, but it has not always been considered as such.
Until the late 1940s, adipose tissue was characterized as a form of connective tissue that was found to contain lipid droplets, without this being significantly related to the body’s metabolism. This began to change gradually with the realization that fat tissue plays a major role in nutrient homeostasis, serving as a site for storing calories after food and as a source of free fatty acids circulating during fasting.
From the late 1980s to the mid-1990s, serum factors derived from adiposity, such as adipsin, TNF-α and Latvia, were discovered. Suddenly, adipose tissue had to be considered an endocrine organ at the centre of energy homeostasis. From that moment on, studies on the developmental, functional and pathophysiological aspects of adipose tissue were considerably expanded. The renewed interest in fat has occurred simultaneously with a considerable increase in the overall rates of obesity and type II diabetes; this is not a coincidence, of course. We have reached the inflection point where the global burden of suffering from overnutrition exceeds that of undernutrition for the first time in human history, with 1.7 billion people classified as obese (Haslam and James, 2005). Given its central role in the homeostasis of energy and glucose, interest in “solving” adipocyte has never been greater and shows no signs of abating.
Fat Tissue Expansion In Obesity: Bigger Vs. More
One of the unique attributes of adipose tissue is its incredible ability to change its dimensions; no other non-plastic tissue shares this characteristic to the same degree. In principle, this can be achieved by increasing the size of individual cells (hypertrophy) or by recruiting new fat cells from the pool of resident progenitors (hyperplasia). In the case of over-nutrition, fat deposits first develop by hypertrophy until they reach a critical threshold (~0.7-0.8 ug/cell), from which signals are emitted that induce proliferation and/or differentiation of pre-adipocytes (Krotkiewski et al., 1983).
In humans, overfeeding for several months causes an increase in cell size but not in cell number (Salans et al., 1971); a more recent version of this study suggests that overfeeding induces hypertrophy of subcutaneous fat in the upper body, but hyperplasia of deposits below the waist (Chukalova et al., 2010). More recently, the labelling of stable isotopes from the mid-century nuclear-weapon tests has been exploited to suggest that fat cell counts settle during childhood and early adulthood, with obese individuals reaching a higher ‘plateau’ (Spalding et al., 2008).
It is interesting to note that once fat cells are gained, they are difficult to lose, as even significant weight loss is associated with a reduction in fat volume but not in total numbers (Bjorntorp et al., 1975; Kral et al., 1977). This does not mean that fat cells never die, as approximately 8% of human subcutaneous fat cells are renewed each year, with birth and death rates matched to cause little change in total cell numbers (Spalding et al., 2008). Fat cells can die by necrosis or apoptosis, although the relative contribution of each process is debated (Cinti et al., 2005).
What Is The Role Of Fatty Tissue?
By far the most important function of adipose tissue is that of a master regulator of energy balance and nutritional homeostasis.
The tendency of fat tissue to store things is an unfortunate side effect, as we often need these things to circulate, not stay in place. Take hormones, for example. Female body fat actually produces some of its own estrogen in addition to storing it, and the more fat a person has, the more estrogen they are exposed to. This is why being overweight increases the risk of breast cancer. Many types of breast cancer are caused by malfunctioning estrogen receptors, which are more likely to go wrong when there is more estrogen to stimulate them.
Vitamins pose the opposite problem. Adiposity sucks up the available fat-soluble vitamins (those hidden in the fatty tissue instead of being excreted in the urine) – A, D, E and K – and often doesn’t leave enough for the rest of the body. Studies suggest that obese people tend to suffer from vitamin D deficiency because everything is hidden in their fat tissue. These vitamins can return as you lose weight and reduce your body fat, you also allow more of your new vitamin D to stay in your bloodstream. Water-soluble compounds can be removed if you take too much, but because the vitamins stored in your fat tissue can continue to build up, you may eventually overdose. It’s rare, but it happens.
Fat is also a (temporarily) safe place to store pollutants and other organic chemicals that might otherwise pose a threat. Organochlorine pesticides accumulate in grease, as do polychlorinated biphenyls in coolants and other chemicals from the “dirty dozen” of environmental contaminants. These banned chemicals can enter your diet in small amounts and are stored in your fat, perhaps because your body wants to sequester them away from your organs. Bodies don’t seem to store enough of them to become toxic, but the constant buildup makes you vulnerable to exposure. And they begin to reappear when you lose weight.
Safe or not, it’s best not to give your body a place to store all the hormones and vitamins it can accumulate. Our bodies aren’t designed to retain excess body fat and stay healthy – that’s why obesity is a risk factor for so many diseases.
This Being Said
You don’t get fat from eating celery! An unbalanced diet, low in antioxidants and polyunsaturated fatty acids and high in saturated fats results in a surplus of adipose tissue and this obesity is a sign of a micronutritional deficiency in the first place. These micronutrients play an important role in inflammation, metabolic syndrome and insulin resistance and can also influence weight loss.
Several authors have also reported that the absorption, distribution, metabolism and excretion of nutrients in obese individuals may be impaired. The most pronounced deficiencies concern minerals (zinc, selenium) and vitamins (folic acid, vitamins A, E, D and B12).5 The latter are markers of oxidative stress that influence metabolic syndrome.6
In addition, certain essential fatty acids such as polyunsaturated fatty acids (omega 3 and omega 6) are also lowered in patients with a body mass index (BMI) > 25 kg/m2. Studies show that omega 3 supplementation has positive effects on metabolic syndrome, insulin resistance and the reduction of plasma triglycerides.
Vitamins A, D and E are reportedly regularly lowered in obese patients. This deficiency may have consequences on the metabolic profile and the various complications of obesity. Vitamin A (β-carotene) exists as retinol in animal products (meat, dairy products, liver, etc.) and as carotenoid provitamins in foods of plant origin (carrots, apricots, etc.).
Minerals, Trace Elements and Water Soluble Vitamins
As with vitamins, certain minerals and trace elements are often lowered in obese people. The most common are zinc, selenium, folic acid and vitamin B12.
These minerals, trace elements and water-soluble vitamins are thought to have several roles to play in mechanisms related to obesity. Several studies, conducted in candidates for bariatric surgery, show deficiencies in important minerals and trace elements in the preoperative period. The most pronounced deficiencies in these obese patients are vitamin B12, folic acid, vitamin D, and potassium. In addition, some authors point out that the higher the BMI, the lower the micronutrient levels. With respect to zinc and selenium, they are both reported to be involved in insulin regulation and more specifically in increasing insulin sensitivity.
It is well known that an excess of fat in the diet promotes weight gain, cardiovascular and metabolic diseases. Moreover, fatty acids are essential for the proper functioning of cells, they are used as an energy substrate, transport and promote the absorption of fat-soluble vitamins (A, D, E and K) and act as a thermal insulator for the body. In addition to the quantitative aspect, the quality of the fats ingested plays an important role in health.
Some Facts About Micronutritional Deficiency After Bariatric Surgery
In the event that an individual chooses to undergo bariatric surgery to address their obesity problem, it is important to note the impact on micronutrient deficiencies.
For comprehensive management, it is important to promote a balanced diet, consisting mostly of whole foods, vegetables, fruit and fish. A diet rich in polyunsaturated fatty acids, particularly omega 3, and foods rich in antioxidant vitamins should be favoured in obese patients.
Menopause And Obesity
Since we already know that daily nutritional intake of vitamins, minerals and trace elements is essential for the proper functioning of all our systems, you now understand the role that adipose tissue plays in the deficiency state of these elements.
If we go back to the fact that female body fat actually produces some of its own estrogen in addition to storing it, and the more a person has adipose tissue, the more they are exposed to estrogen, we understand that adipose tissue creates a whirlwind of side effects that have an impact on menopausal symptoms.